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When (and how) to stop taking a drug

Last updated: November 2010

Nearly 40 percent of adults in the U.S. 60 or older take at least five prescription drugs, and there's a good chance that at least one of them is unnecessary. Maybe they're drugs like sleeping pills that many people take long-term even though they generally shouldn't. Perhaps they're drugs that are no longer needed because lifestyle changes have helped resolve the problem. Or maybe they were improperly prescribed in the first place.

Whatever the reason, unnecessary medication poses needless risks and expense. But knowing when it's safe to stop isn't always easy. And even when stopping is OK, knowing how can be complicated, since it often requires tapering off over weeks to prevent withdrawal reactions. Here are some tips:

Don't stop on your own. Call your doctor before stopping unless you're having a severe allergic reaction or other life-threatening side effect.

Do a drug check. Bring all of your drugs to your doctor at least once a year to ask whether any can be eliminated.

Make a plan. For drugs that can be discontinued, work out a withdrawal schedule that includes follow-up visits.

Know the warning signs. Get a list of the symptoms that can be triggered by stopping the drug you're taking, and call your doctor if you notice any.

Drug*	Risks of long-term use**	Risk of stopping abruptly**
Antidepressants, such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)	Dependence, sexual dysfunction, and weight changes	Agitation, anxiety, confusion, insomnia, nightmares, nausea, and worsened, severe depression
Benzodiazepines, such as alprazolam (Xanax), lorazepam (Ativan), and triazolam (Halcion), used for anxiety, insomnia, and panic attacks	Dependence, dizziness, impaired coordination, memory loss, sexual dysfunction, and weight changes	Agitation, anxiety, fast heartbeat, hallucinations, insomnia, seizures, sweating, tremors, and nausea
Cholesterol-lowering statins, such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor)	Cataracts, kidney or liver dysfunction, and muscle damage	Rebound high cholesterol levels and heart attack
Corticosteroids, such as beclomethasone (Beconase AQ, QVAR), fluticasone (Flonase, Flovent), and hydrocortisone, for asthma, arthritis, rhinitis, and certain skin problems	Bone loss, cataracts, glaucoma, elevated glucose levels, infection, menstrual irregularities, and impaired ability of the adrenal gland to produce cortisol	Fatigue, low blood pressure, muscle aches and pain, nausea, and weight loss
Heartburn drugs, such as esomeprazole (Nexium) and omeprazole (Prilosec)	Fractures, gastrointestinal infections, and pneumonia	Rebound heartburn
Hormone therapy, such as estrogen (Premarin) and estrogen with progestin (Prefest, Prempro)	Blood clots, heart attacks, strokes, and breast and endometrial cancers	Menopausal symptoms, such as hot flashes, flushes, and sweating
Nonsteroidal anti-inflammatories (NSAIDs),such as celecoxib (Celebrex) and ibuprofen (Advil), and aspirin	Gastrointestinal bleeding. With NSAIDs, heart attacks and strokes	Heart attack (when you abruptly stop aspirin) and headaches (when you stop NSAIDs).
Opioids, such as hydrocodone, oxycodone, and propoxyphene	Constipation, dependence, drowsiness, mood swings, and nausea	Agitation, chills, cramps, diarrhea, hostility, insomnia, muscle pain, and vomiting
Sleep aids, such as eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien)	Dependence, memory loss, dizziness, nightmares, sleep driving, and worsened sleep	Anxiety, muscle cramps, nausea, and seizures

Clarification: * Many of the listed drugs are also available as generics.

** Not all of the risks apply to all of the listed drugs.

These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin.

If you think you have experienced an adverse event with this drug or any drug, especially if it is of a serious nature, it is important to 1) tell your doctor immediately and 2) report the event to the Food and Drug Administration via the FDA's MedWatch Web site at www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm or by calling 1-800-FDA-1088.

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